You review Rose’s case with Jacinta, the Aboriginal Mental Health Worker and a translator and, as a result of Rose’s condition you decide to do some basic cognitive testing.  You also consult with an occupational therapist and ask them to do an assessment with Rose as well.  In co-ordination with her treating renal team, you organise a dementia screen including a CT brain scan and serological investigations including B12, folate and thyroid function.

Rose’s CT scan shows significant cortical atrophy along with white matter attenuation consistent with microvascular lesions.  The serological investigations are normal.  Simple, culturally appropriate cognitive testing shows significant deficiencies.  Her renal physician, in consultation with a neurologist and yourself feels that dementia of mild to moderate intensity is the most likely diagnosis.